AccountId: 011433970860
ContactId: 42b1bce0-ad53-458e-b82e-76c299eb3cfc
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 837659 ms
Total Talk Time (AGENT): 258171 ms
Total Talk Time (CUSTOMER): 229308 ms
Interruptions: 0
Overall Sentiment: AGENT=0.2, CUSTOMER=-0.3
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/24/42b1bce0-ad53-458e-b82e-76c299eb3cfc_20250324T14:29_UTC.wav
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[AGENT][POSITIVE] Good morning. Thank you for calling APL. My name is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hi. My name is [PII]. I'm calling from the provider's office on a claim.
[AGENT][POSITIVE] OK, well, I'll be more than happy to assist you with the claim status, and did you say your name is [PII]?
[CUSTOMER][NEUTRAL] Uh yes.
[AGENT][NEUTRAL] OK, and [PII], may I have a good contact number in case we're disconnected?
[CUSTOMER][NEUTRAL] Uh yes, so it's uh [PII] and no extension.
[AGENT][NEUTRAL] Thank you for that. And may I have the member's policy number?
[CUSTOMER][NEUTRAL] Yeah sure.
[CUSTOMER][NEUTRAL] The policy number will be D as in Delta 42031349.
[AGENT][NEUTRAL] Thank you. And do you have the member's ID card available?
[CUSTOMER][NEUTRAL] Uh, just a moment, I'll check.
[CUSTOMER][NEUTRAL] What
[CUSTOMER][NEUTRAL] Yes, so I do have an ID card.
[AGENT][NEUTRAL] OK, on the ID card, do you see anywhere that says in hospital or outpatient policy certificate number?
[CUSTOMER][NEUTRAL] Uh, sorry, what number you need?
[CUSTOMER][NEUTRAL] Yeah
[AGENT][NEUTRAL] It should say in hospital or outpatient policy certification number, um, it should start with a 01 or 02.
[CUSTOMER][NEUTRAL] Just a moment.
[CUSTOMER][NEUTRAL] Uh, no, I don't have any number here.
[AGENT][NEUTRAL] OK, I can also search the policy with the member's first and last name or the social.
[CUSTOMER][NEUTRAL] Uh yes. So you can go with uh social.
[AGENT][NEUTRAL] Or
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] So it's [PII].
[AGENT][NEUTRAL] Thank you, hold on one moment.
[CUSTOMER][NEUTRAL] Uh-huh.
[AGENT][NEUTRAL] So I'm just waiting for the policy. Hold on one moment.
[CUSTOMER][NEUTRAL] Mhm
[AGENT][NEUTRAL] And [PII], do you mind if I place you on just a brief hold?
[CUSTOMER][POSITIVE] Oh yes, sure. Take your time.
[AGENT][NEUTRAL] All right, hold on one moment.
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][NEUTRAL] Alright now I come on.
[AGENT][NEGATIVE] This one is frozen 2 is lying down.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][NEUTRAL] Hello, [PII].
[CUSTOMER][NEUTRAL] Oh yes, same here.
[AGENT][POSITIVE] Thank you so much for holding. I apologize for that wait. So with the social, um, no policy came up, what is the member's first and last name I can try with their name?
[CUSTOMER][NEUTRAL] Yes. So, the member's first name will be [PII], which spells [PII], and the last name spells like [PII], uh, which spells like [PII].
[CUSTOMER][NEUTRAL] And the member's date of birth is on [PII].
[AGENT][NEUTRAL] OK, hold on one moment, let me search with the name.
[AGENT][NEUTRAL] On their ID card, do you see APL to the top left corner?
[CUSTOMER][NEUTRAL] Just a moment.
[AGENT][NEUTRAL] Sure.
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Ah, it shows like crown so.
[AGENT][NEUTRAL] I'm sorry?
[CUSTOMER][NEUTRAL] Uh, it shows like crown service.
[CUSTOMER][NEUTRAL] I
[AGENT][NEUTRAL] OK. The reason I'm asking is because the policy didn't come up with the social, the member ID we can't use, and I'm waiting to see if a policy comes up with the name, but if it doesn't,
[CUSTOMER][NEUTRAL] But
[AGENT][NEUTRAL] Um, do you have a claim number?
[CUSTOMER][NEUTRAL] Oh just a moment.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Well.
[CUSTOMER][NEUTRAL] Uh, no, I don't have a claim number with me.
[AGENT][NEUTRAL] OK, um,
[AGENT][NEUTRAL] I'm waiting for it to, yeah, we don't have a policy um for member [PII]. So, um, I would either reach out to the member or um
[AGENT][NEUTRAL] I, I will reach out to the member and see what insurance they have.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] OK, but, uh, here in Gay they stated like it's for 90 degree benefit and it's for crown service that uh reached to this number.
[AGENT][NEUTRAL] Right, but this is APL.
[AGENT][NEUTRAL] So did you dial an [PII] number or [PII] number?
[CUSTOMER][NEUTRAL] Uh-huh.
[CUSTOMER][NEUTRAL] It's [PII].
[AGENT][NEUTRAL] Right, so you're trying to reach.
[AGENT][NEGATIVE] So you're trying to reach 90 degree benefits, but you were redirected to American Public Life. So you can hang up and call the [PII] and press 0 for customer service because uh APL is a different company, but we do work with 90-degree benefits. This member just doesn't have a policy with us.
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] OK, so is there a possibility to uh transfer the call or allow the call to that insurance?
[AGENT][NEUTRAL] So what the, so APL does not know who the member has insurance with. Are you asking me to transfer you back to 90 Degree benefits?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK, before I transfer you, is there anything else I can assist you with today?
[CUSTOMER][NEUTRAL] Uh yes, so, uh, before, uh, transferring, I just want to confirm the, uh, the claim's mailing address. So it's [PII], right?
[AGENT][NEUTRAL] OK, so the member doesn't have a policy with us, so I can't confirm that. That that claim's mailing address is to IMA if that I mean that's the correct address for IMA but I don't know what type of policy they have to tell you that's correct because they don't have a policy with APL.
[CUSTOMER][NEUTRAL] Oh
[CUSTOMER][NEUTRAL] No
[CUSTOMER][NEUTRAL] Uh, OK, perfect. And uh could you please spell your name for me for the documentation purpose?
[AGENT][NEUTRAL] Yes, my name is [PII] First initial to my last name is L [PII].
[CUSTOMER][POSITIVE] Thank you, [PII].
[CUSTOMER][NEUTRAL] And so can I get the call reference number for your call today?
[AGENT][NEUTRAL] Sure, so there's no call reference number, but you can use my name and today's date. The first initial to my last name is [PII].
[CUSTOMER][NEUTRAL] OK, thank you, [PII]. And uh could you please transfer the call or the call to that that insurance company.
[AGENT][NEUTRAL] Yes, um, before I transfer you, is there anything else I can help with?
[CUSTOMER][NEUTRAL] No, that's all, [PII].
[AGENT][NEUTRAL] Alright, well, thanks for calling APL and hold on one moment for your transfer.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEUTRAL] Thank you for calling 90 Degree Benefits, the administrator for benefits in a card members. Please select from the following options to ensure you are directed to the appropriate party to answer your questions. For questions on IMA Mec Wellness, MVP plans, or COBRA enrollment, please press 1. For questions on the APL hospital indemnity plans or dental coverage, please press 2. For questions on the vision plan, please press 3.
[CUSTOMER][NEUTRAL] If you are an employee and you have questions on your active enrollment, please press 4.
[CUSTOMER][NEUTRAL] To hear this message again, please press the star key. Thank you.
[CUSTOMER][NEUTRAL] If you would like to participate in a quick survey after the call to rate your service with us, please press 1. Press 2 if no.
[CUSTOMER][NEUTRAL] Thank you for calling 90 Degree Benefits. This is [PII]. How can I help you?
[AGENT][NEUTRAL] Hi, [PII], this is [PII] from APL. I have a member on the uh provider on the other line who is trying to um do a claim status. It sounds like they're trying to reach y'all um because they don't have a policy with us and she was trying to dial this number but she was redirected to us.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Um, did you need any of her information or anything? I just have her name and callback number and the member she's trying to locate.
[CUSTOMER][NEUTRAL] What's that member ID number?
[AGENT][NEUTRAL] Uh well, we don't, um.
[CUSTOMER][NEUTRAL] Oh, do you, do
[AGENT][NEUTRAL] Let me see if this works.
[AGENT][NEUTRAL] Go ahead.
[CUSTOMER][NEUTRAL] Do I need to call her back? I'm sorry, I'm still, I'm still training.
[AGENT][NEGATIVE] No, no.
[AGENT][NEUTRAL] It's OK. So she's on the other line. I'm just gonna transfer her to you. She's trying to get a claim status, but I do have like the D number y'all have, but we can't use that in our system. So I tried to search the number with like their social and their name, but we didn't have anything.
[CUSTOMER][POSITIVE] Got you.
[CUSTOMER][NEGATIVE] Gotcha.
[AGENT][NEUTRAL] Did you, does it, you want me to give you that number?
[CUSTOMER][NEUTRAL] You can what's that number?
[AGENT][NEUTRAL] OK, so it's D like dog, 42031349.
[CUSTOMER][NEUTRAL] What's the patient's name?
[AGENT][NEUTRAL] She's looking for [PII], um, date of birth [PII].
[CUSTOMER][NEUTRAL] All right, we have them in our system.
[AGENT][NEUTRAL] OK, good. I thought so. OK, and her name is [PII].
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Alright, hold on one moment, and can you repeat your name for me? I'm sorry.
[CUSTOMER][NEUTRAL] My name is [PII].
[AGENT][NEUTRAL] [PII], OK. Hold on one moment. Are you ready?
[CUSTOMER][NEUTRAL] Uh-huh.
[AGENT][NEUTRAL] OK
[AGENT][NEUTRAL] Hello, [PII].
[CUSTOMER][NEUTRAL] Uh, yes, I'm here.
[AGENT][POSITIVE] Thank you so much for holding. I have [PII] on the line and she'll be assisting you further, OK?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Hello?
[CUSTOMER][NEUTRAL] Uh hello. Hi, my name is [PII] and I'm